ABSTRACT
Saudi Arabia appears to have an unusually high incidence of hepatocellular carcinoma, which has been causally associated with a high prevalence of hepatitis B virus [HBV]. Other risk factors, including hepatitis C virus [HCV] infection are currently not known. A study was undertaken to establish the risk factors and clinicopathological features of hepatocellular carcinoma in Saudi Arabia. The profiles of 140 patients with a biopsy-proven hepatocellular carcinoma were analyzed. Demographic data revealed a strong male preponderance [male:female = 5.7:1] and 114 patients [81.4%] were found to have or have had HBV infection. The data concerning HCV infection were incomplete, but suggest a causal association [nine of 33 patients]. An absence of alcohol as a risk factor was noteworthy. Clinical jaundice and right upper quadrant abdominal pain were the most frequent presenting features. Abnormal liver function tests were present in 125 patients [89.3%] at diagnosis and serum alpha fetoprotein was elevated in 112 patients [80%]. The majority of patients had locally advanced, inoperable disease and the prognosis was uniformly dismal. The median survival was 61 days